Abstract
The need for calibrated imaging of polycystic ovaries is now stronger than ever since the consensus conference held in Rotterdam in May 2003 to establish the diagnosis of the polycystic ovary syndrome. However, imaging polycystic ovaries is not an easy procedure, and it requires a thorough technical and medical background. Two-dimensional ultrasonography remains the standard for imaging polycystic ovaries, and the current consensus definition of polycystic ovaries determined at the joint Rotterdam meeting rests on this technique. The definition includes either 12 or more follicles measuring 2–9 mm in diameter and/or increased ovarian volume (>10 cm3) in at least one ovary. Other imaging techniques, such as Doppler and three-dimensional ultrasonography, can help in the diagnosis, but should be considered second-line techniques.
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References
Balen AH, Laven JSE, Tan SL, Dewailly D. Ultrasound assessment of the polycystic ovary: international consensus definitions. Hum Reprod Update 2003;9:505–514.
The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004;19:41–47.
Hughesdon PE. Morphology and morphogenesis of the Stein-Leventhal ovary and of so-called “hyperthecosis.” Obstet Gynecol Survey 1982;37:59–77.
Webber LJ, Stubbs S, Stark J, et al. Formation and early development of follicles in the polycystic ovaries. Lancet 2003;362:1017–1021.
Jacobs HS. Polycystic ovaries and polycystic ovary syndrome. Gynecol Endocrinol 1987;1:113–131.
Maciel G, Chang RJ, Erickson GF. Evidence for stockpiling of classic primary preantral follicles in PCOS ovaries. Endocrine Society Congress, New Orleans, June 16-19, 2004, Poster 1-531.
Jonard S, Dewailly D. The follicular excess in polycystic ovaries, due to intra-ovarian hyperandrogenism, may be the main culprit for the follicula arrest. Hum Reprod Update 2004;10:107–117.
Sample WF, Lippe BM, Gyepes MT. Grey-scale ultrasonography of the normal female pelvis. Radiology 1977; 125:477–483.
Adams Jm, Polson DW, Abulwadi N, et al.. Multifollicular ovaries: clinical and endocrine features and response to pulsatile gonadotropin-releasing hormone. Lancet 1985;2:1375–1378.
Orsini LF, Venturoli S, Lorusso R. Ultrasonic findings in polycystic ovarian disease. Fertil Steril 1985;43:709–714.
Yeh HC, Futterweit W, Thornton JC. Polycystic ovarian disease: US features in 104 patients. Radiology 1987;163:111–116.
Van Santbrink EJP, Hop WC, Fauser BCJM. Classification of normogonadotropic infertility: polycystic ovaries diagnosed by ultrasound versus endocrine characteristics of polycystic ovary syndrome. Fertil Steril 1997;67:452–458.
Jonard S, Robert Y, Dewailly D. Revisiting the ovarian volume as a diagnostic criterion for polycystic ovaries. Hum Reprod 2005;20:2893–2898.
Jonard S, Robert Y, Cortet-Rudelli C, Pigny P, Decanter C, Dewailly D. Ultrasound examination of polycystic ovaries:is it worth counting the follicles? Hum Reprod 2003;18:598–603.
Adams JM, Taylor AE, Crowley WF Jr, Hall JE. Polycystic ovarian morphology with regular ovulatory cycles: insights into the pathophysiology of polycystic ovarian syndrome. J Clin Endocrinol Metab 2004;89:4343–4350.
Venturoli S, Porcu E, Fabbri R, Paradisi R, Orsini LF, Flamigni C. Ovaries and menstrual cycles in adolescence. Gynecol Obstet Invest 1983;17:219–223.
Stanhope R, Adams J, Jacobs HS, Brook CG. Ovarian ultrasound assessment in normal children, idiopathic precocious puberty, and during low dose pulsatile gonadotrophin releasing hormone treatment of hypogonadotrophic hypogonadism. Arch Dis Child 1985;60:116–119.
Reyss AC, Merlen E, Demerle C, Dewailly D. Revelation of a polymicrocystic ovary syndrome after one month’s treatment by pulsatile GnRH in a patient presenting with functional hypothalamic amenorrhea. Gynecol Obstet Fertil. 2003;31:1039–1042.
Ardaens Y, Robert Y, Lemaitre L, Fossati P, Dewailly D. Polycystic ovarian disease: contribution of vaginal endosonography and reassessment of ultrasonic diagnosis. Fertil Steril 1991;55:1062–1068.
Dewailly D, Robert Y, Helin I, et al. Ovarian stromal hypertrophy in hyperandrogenic women. Clinical Endocrinology 1994;41:557–562.
Robert Y, Dubrulle F, Gaillandre G, et al. Ultrasound assessment of ovarian stroma hypertrophy in hyperandrogenism and ovulation disorders: visual analysis versus computerized quantification. Fertil Steril 1995;64:307–312.
Pache TD, Wladimiroff JW, Hop WCJ, Fauser BCJM. How to descriminate between normal and polycystic ovaries: transvaginal US study. Radiology 1992;183:421–423.
Fulghesu AM, Ciampelli M, Belosi C, Apa R, et al. A new ultrasound criterion for the diagnosis of polycystic ovary syndrome: the ovarian stroma/ total area ratio. Fertil Steril 2001;76:326–331.
Pache TD, Hop WC, Wladimiroff JW, Schipper J, Fauser BCJM. Transvaginal sonography and abnormal ovarian appearance in menstrual cycle disturbances. Ultrasound Med Biol 1991; 17:589–593.
Al-Took S, Watkin K, Tulandi T, Tan SL. Ovarian stromal echogenicity in women with clomiphene citrate-sensitive and clomiphene citrate-resistant polycystic ovary syndrome. Fertil Steril 1999;71:952–954.
Buckett WM, Bouzayen R, Watkin KL, Tulandi T, Tan SL. Ovarian stromal echogenicity in women with normal and polycystic ovaries. Hum Reprod 1999;14:618–621.
Battaglia C, Artini PG, Salvatori M, Giulini S, Petraglia F, Maxia N, Volpe A. Ultrasonographic pattern of polycystic ovaries: color Doppler and hormonal correlations. Ultrasound Gynaecol Obstet 1998;11:332–336.
Wu M-H, Tang H-H, Hsu C-C, Wang S-T, Huang K-E. The role of three-dimensional ultrasonographic imaging in ovarian measurment. Fertil Steril 1998;69:1152–1155.
Kyei-Mensah A, Maconochie N, Zaidi J, Pittrof R, Campbell S, Tan SL. Transvaginal three-dimensional ultrasound: accuracy of ovarian follicular volume measurements. Fertil Steril 1996;65:371–376.
Kyei-Mensah A, Zaidi J, Campbell S. Ultrasound diagnosis of polycystic ovary syndrome. Bailliere’s Clin Endocrinol Metab 1996;10:249–262.
Kyei-Mensah A, Tan SL, Zaidi J, Jacobs HS. Relationship of ovarian stromal volume to serum androgen concentrations in patients with polycystic ovary syndrome. Hum Reprod 1998;13:1437–1441.
Nardo LG, Buckett WM, Khullar V. Determination of the best-fitting ultrasound formulaic method for ovarian volume measurement in women with polycystic ovary syndrome. Fertil Steril 2003;79:632–633.
Battaglia C, Artini PG, Genazzani AD, Sgherzi MR, Salvatori M, Giulini S, Volpe A. Color Doppler analysis in lean and obese women with polycystic ovaries. Ultrasound in Gynaecology and Obstetrics 1996;7:342–346.
Battaglia C, Genazzani AD, Salvatori M, Giulini S, et al. Doppler, ultrasonographic and endocrinological environment with regard to the number of small subcapsular follicles in polycystic ovary syndrome. Gynecol Endocrinol 1999;13:123–129.
Aleem FA, Predanic MP. Transvaginal color Doppler determination of the ovarian and uterine blood flow characteristics in polycystic ovary disease. Fertil Steril 1996;65:510–516.
Zaidi J, Campbell S, Pittrof R, et al. Ovarian stromal blood flow in women with polycystic ovaries: a possible new marker for diagnosis? Hum Reprod 1995,10:1992–1996.
Agrawal R, Conway G, Sladkevicius P, et al. Serum vascular endothelial growth factor and Doppler blood flow velocities in in vitro fertilization: relevance to ovarian hyperstimulation syndrome and polycystic ovaries. Fertil Steril 1998;70:651–658.
Engmann L, Sladkevicius P, Agrawal LR, Bekir JS, Campbell S, Tan SL. Value of ovarian stromal blood flow velocity measurement after pituitary suppression in the prediction of ovarian responsiveness and outcome of in vitro fertilization treatment. Fertil Steril 1999;71:22–29.
Takayama K, Fukaya T, Sasano H, Funayama Y, et al. Immunohistochemical study of steroidogenesis and cell proliferation in polycystic ovarian syndrome. Hum Reprod 1996;11:1387–1392.
Pigny P, Merlen E, Robert Y, Cortet-Rudelli C, et al. Elevated serum level of anti-mullerian hormone in patients with polycystic ovary syndrome: relationship to the ovarian follicle excess and to the follicular arrest. J Clin Endocrinol Metab 2003;88:5957–5962.
Goldzieher JW, Green JA. The polycystic ovary. I. Clinical and histologic features. J Clin Endocrin Metabol 1962;22:325–338.
Atiomo WU, Pearson S, Shaw S, Prentice A, Dubbins P. Ultrasound criteria in the diagnosis of polycystic ovary syndrome (PCOS). Ultrasound Med Biol 2000;26:977–980.
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Jonard, S., Robert, Y., Ardaens, Y., Dewailly, D. (2006). Ovarian Histology, Morphology, and Ultrasonography in the Polycystic Ovary Syndrome. In: Azziz, R., Nestler, J.E., Dewailly, D. (eds) Androgen Excess Disorders in Women. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-179-6_16
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DOI: https://doi.org/10.1007/978-1-59745-179-6_16
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